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Ontario

Major medicare expansion as young get free Rx drugs

A new prescription drug program that covers all Ontario residents until their 25th birthday is a major step toward a national pharmacare program, Health Minister Dr. Eric Hoskins predicts.

OHIP+ allows any child, teen or young adult with a health card to access the roughly 4,400 prescription drugs on the provincial formulary without charge starting Jan. 1.

“They don’t have to pay at all; there’s no co-payment; there’s no annual deductible,” Hoskins said in a recent interview. “And it will cover the run of the mill stuff that you can imagine like asthma inhalers, puffers, the insulin for diabetics, plus the insulin supplies, EpiPens...the more expensive ones like drugs for rare diseases as well as cancer drugs.”

As health care increasingly means prescription medication, many stakeholders in the health care system have advocated for a national pharmacare program as a logical expansion of medicare.

As a family doctor, Hoskins is aware of the need for such a program and has been pushing hard on the national stage for several years.

Premier Kathleen Wynne is committed to working toward universal pharmacare program for all Ontarians, he said.

Seniors and residents on social assistance already have significant coverage, although with some fees, so the next logical step was to add those 24 years of age and under, he said.

The government chose to go up to 24 years of age to ensure that young adults in college or university or the workplace are not without coverage, he said.

OHIP+ comes with a healthy price tag — $450 million a year.

But Hoskins said an estimated one in 10 families choose not to fill prescriptions because they can’t afford them.

“I can’t tell you the number of times where I hand over a prescription and I know that the family isn’t going to fill it or can’t afford it, or I go over to the cabinet or the drawer which is full of samples to see if I can find rarely the drug of choice, but something close enough that will kind of do the job that I can then give to the patient,“ Hoskins added.

Preventing a disease from advancing comes with its own savings in ER and other health care costs, he said,

“The other part of this is showing the rest of Canada what can be done,” Hoskins said. “I’ve been relentless in pushing for national pharmacare. And we made some really great progress, and so part of it is we want to put our money where our mouth is and show other Canadian provinces and territories that this can be done.”

Many children and youth do have prescription drug coverage through their parents’ work benefits.

Hoskins said Ontario+ will be the first payer, meaning families won’t have to access their work coverage at all for the vast majority of prescription drugs.

That means significant savings for workplace insurers, but Hoskins said he expects benefits to be expanded, or for employers and employees to see reductions in those costs.